Renal Replacement Lipomatosis: A Rare and Often Ignored Entity

A 54-year-old elderly hypertensive female presented to urosurgery outpatient department with complaint of in-creased frequency and on and off pain in the left flank for five years, occurring every 10 to 15 days with moderate to severe intensity and relieved spontaneously with medi-cations. The clinical examination was unremarkable. Her hypertension was under control with medication. Urine routine microscopy, renal function tests and serum electro-lytes were within the normal range. A Computed Tomo-graphy (CT) of the abdomen suggested a small sized left kidney with a staghorn calculus of size 39×38×15 mm and near total replacement of renal parenchyma by fat density (Fig. 1). A Dimercaptosuccinic acid scan (DMSA) suggested a non-functioning left kidney. Left simple nephrectomy was performed and the specimen was sent to the department of pathology. The left kidney